title: Activity of thalidomide and capecitabine in patients with advanced hepatocellular carcinoma.
abstract: BACKGROUND
  Thalidomide has shown modest activity in advanced hepatocellular carcinomas (HCCs). Single-agent capecitabine has also been used in patients with HCC, with objective responses being reported. In our study, we review the use of thalidomide and capecitabine combination in advanced HCC.
  
  
  METHODS
  From November 2003 and September 2008, 42 patients with advanced HCC who were not eligible for clinical trial or conventional chemotherapy were treated with oral capecitabine (2000 mg/m/d) for 14 days every 3 weeks and oral thalidomide at the doses of 50 to 200 mg/d.
  
  
  RESULTS
  Almost 50% of patients had Child-Pugh B or C liver cirrhosis and a history of regional or systemic therapy. Three patients achieved complete responses lasting more than 52 weeks, including 1 patient who achieved pathological complete response and underwent curative resection. There were 3 patients with partial responses and 13 with stable disease. Median overall survival of all 42 patients was 9.9 months. The median progression-free survival was 5.1 months. The presence of ascites, portal vein thrombosis, and poorer Child-Pugh liver cirrhosis status also resulted in significantly poorer survival outcome. Treatment was well tolerated. Fatigue was the most common side effect occurring in 16 (38%) patients, but only 1 patient had grade 3 toxicity and had to stop treatment. Two other patients developed grade 3 palmar-plantar erythrodysesthesia from capecitabine.
  
  
  CONCLUSIONS
  The combination of thalidomide and capecitabine has activity in advanced HCC and can result in complete pathological response. Treatment is well tolerated even in less-fit patients who have been pretreated and deserve further study.
authors.affiliation: Department of Medical Oncology, National Cancer Centre, Singapore 11, Hospital Drive, Singapore. ang.s.f@nccs.com.sg
authors.forename: Soo-Fan
authors.initials: SF
authors.lastname: Ang
authors.forename: Sze-Huey
authors.initials: SH
authors.lastname: Tan
authors.forename: Han-Chong
authors.initials: HC
authors.lastname: Toh
authors.forename: Donald Y H
authors.initials: DY
authors.lastname: Poon
authors.forename: Simon Y K
authors.initials: SY
authors.lastname: Ong
authors.forename: Kian-Fong
authors.initials: KF
authors.lastname: Foo
authors.forename: Su-Pin
authors.initials: SP
authors.lastname: Choo
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000069287:Capecitabine; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013792:Thalidomide / Q000008:administration & dosage
chemical_list: D003841:Deoxycytidine; D013792:Thalidomide; D000069287:Capecitabine; D005472:Fluorouracil